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Are individual-level risk factors for gastroschisis modified by neighborhood-level socioeconomic factors?
Journal article   Peer reviewed

Are individual-level risk factors for gastroschisis modified by neighborhood-level socioeconomic factors?

Dayna T. L. Neo, Chantel L. L. Martin, Suzan L. Carmichael, Muge M. Gucsavas-Calikoglu, Kristin M. Conway, Shannon Pruitt L. Evans, Marcia L. M. Feldkamp, Suzanne M. Z. Gilboa, Tabassum Z. I. Insaf, Fadi I. M. Musfee, …
Birth defects research, Vol.115(15), pp.1438-1449
09/01/2023
DOI: 10.1002/bdr2.2224
PMCID: PMC10527855
PMID: 37439400

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Abstract

Background: Two strong risk factors for gastroschisis are young maternal age (<20 years) and low/normal pre-pregnancy body mass index (BMI), yet the reasons remain unknown. We explored whether neighborhood-level socioeconomic position (nSEP) during pregnancy modified these associations.Methods: We analyzed data from 1269 gastroschisis cases and 10,217 controls in the National Birth Defects Prevention Study (1997-2011). To characterize nSEP, we applied the neighborhood deprivation index and used generalized estimating equations to calculate odds ratios and relative excess risk due to interaction.Results: Elevated odds of gastroschisis were consistently associated with young maternal age and low/normal BMI, regardless of nSEP. High-deprivation neighborhoods modified the association with young maternal age. Infants of young mothers in high-deprivation areas had lower odds of gastroschisis (adjusted odds ratio [aOR]: 3.1, 95% confidence interval [CI]: 2.6, 3.8) than young mothers in low-deprivation areas (aOR: 6.6; 95% CI: 4.6, 9.4). Mothers of low/normal BMI had approximately twice the odds of having an infant with gastroschisis compared to mothers with overweight/obese BMI, regardless of nSEP (aOR range: 1.5-2.3).Conclusion: Our findings suggest nSEP modified the association between gastroschisis and maternal age, but not BMI. Further research could clarify whether the modification is due to unidentified biologic and/or non-biologic factors.
Developmental Biology Toxicology Life Sciences & Biomedicine Science & Technology

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